Healthcare Provider Details

I. General information

NPI: 1962364554
Provider Name (Legal Business Name): ALISHA CHRISTENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10502 N AMBASSADOR DR STE 201
KANSAS CITY MO
64153-1291
US

IV. Provider business mailing address

4721 S CLIFF AVE STE 103
INDEPENDENCE MO
64055-6969
US

V. Phone/Fax

Practice location:
  • Phone: 816-608-1951
  • Fax: 800-687-5070
Mailing address:
  • Phone: 816-608-1956
  • Fax: 800-687-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: